Five Things I Learned Dealing with a DCS Emergency

[drrich2]

Good to know. Thanks! I work in the mental health field; Neurology is not my thing!

Richard.

 

[denniscloutier]

I'm too lazy to go to Rubicon and look up citations, but I believe it is almost universally believed that multiple sequential days of diving results in cumulative load in the slower tissues -- which is why the recommendation of time to fly is longer if you have done multiple dives/multiple days. Those hits tend to be Type I, however, unlike this one.

I have been using the 24 hours till you can fly rule. Is this recommended for a one or two or three week trip?

By the way, what is a PFO. (I did do a search, but I came up empty)

Thanks,

 

[Dirty-Dog]

There certainly could be more subtle findings that wouldn't be as clear-cut, but we generally don't treat subtle findings with clot-busting drugs (the only effective treatment -- and it's of controversial effectiveness -- for stroke), so hyperbaric oxygen is unlikely to hurt the patient, and if it's DCS, it will help.

But this is why an examination by a medical professional IS called for in such cases.

Absolutely. Every single time I've given thrombolytics for a presumed CVA and seen improvement, I've wondered if we had just exposed the patient to a HUGE risk for a TIA. Maybe someday we'll have a fast and reliable method of distinguishing between ischemic CVA and TIA.

 

[Dirty-Dog]

By the way, what is a PFO. (I did do a search, but I came up empty)

Thanks,

Patent Foramen Ovale. It's a hole in the heart that lets blood shift from the left atrium to the right prior to birth. It normally closes shortly after birth as part of the transition from fetal to neonatal circulation.

 

[farsidefan1]

My PFO was discovered by the saline solution and echo thingy. 25 to 30% of people have the PFO which is a condition caused by the failure of the atrium chambers to grow the wall completely closed after birth. Unless you have migrain problems, DCS or stroke problems then people can go through life and never even know they have a PFO. They placed a metal device that looks like 2 umbrellas through the hole and then expanded the umbrellas to hold it in place. That was December 23rd. Last week they did their echo thing again to verify it was in place and functional. I'll be diving in June. For a month after the PFO procedure they told me not to do ANYTHING but then I'd be fine. Since I had major shoulder surgury Dec. 3rd I was fine with another month off. Tough December and January but I'm now back on the treadmill and exercycle trying to get ready for mountain biking and scuba.

 

[Eff]

Oh, you ride too? Good stuff. I mainly use a SS 26 hardtail [rolling flowy terrain here in NJ area, no drawn out steep climbs so to speak] these days - got tired of doing the constant maintenance on the rear der + suspension.

My next ride will prolly be a 29er SS rigid. I find my road bike keeps getting more and more tricked out, and my mtn bike is becoming ever simpler so I can just ride...


To keep this on topic; thanks for elaborating on the test and corrective procedure. It's neat to know that a PFO can be treated as such.

 

[arkstorm]

Quick follow-up: Its been a little over a month since the incident and the symptoms are completely cleared up. It would appear that we who witnessed the incident learned much more from it than the actual victim because, despite not having isolated the exact cause, he's ready to dive again.

 

[farsidefan1]

Good luck with dad. As I said, I totally understand where he is coming from. Oh, and Eff, I ride a Santa Cruz blur with full suspension. My butt prefers that suspension. I don't do much on roads, them cars'll kill ya.

 

[avidiver]

Estimado Arkstorm,

Allow me to thank you for all you've written up.

I would like to add 2 things:
When we talk about oxygen, not all are equal.
We carry 100% oxygen through demand valve regulators.
The demand valve regulators are expensive, but they provide 100% Oxygen.
Beware of simple canula or ventilated mask systems; they provide 40 -50 % O2.
On dive boats, that's just for show in my opinion.

In your father's case, since he had severe symptoms reported from the boat,
you will recall our discussion about oxygen masking DCS symptoms,
and the fear that if your father flatly refused to get in the chamber,
he could drop in a few hours and remain a paraplegic. I've seen that happen.

So, in my humble experience, not all oxygen is equal so let's specify 100% oxygen,
and beware; oxygen often masks hyperbaric symptoms. You go in the chamber if you could not get up off the deck a half hour prior to feeling fine. That is important. Beware of oxygen masked symptoms.
Saludos from sunny Cozumel,
Aqua Safari
Bill Horn

 

[kaerius]

When we talk about oxygen, not all are equal.
We carry 100% oxygen through demand valve regulators.
The demand valve regulators are expensive, but they provide 100% Oxygen.
Beware of simple canula or ventilated mask systems; they provide 40 -50 % O2.
On dive boats, that's just for show in my opinion.

You need three systems to provide oxygen on a dive boat really... the resuscitator mask with freeflow(for non-breathing, CPR), same mask with demand valve(breathing diver), and a non-rebreather mask(weakly breathing diver).

The non-rebreather masks are one-use.

But I will reiterate that not all dive operations are equal. If I remember my data right, on Koh Tao(dive capital of the world), of the 40-50 odd dive operations, about 20 have O2 onboard, about as many have surface cover, about 10 have rollcalls, and about 5 use droptanks.

I got my training done on one that had all of the above.